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Amy C. Justice, M.D., Ph.D.
blue arrow Associate Professor, Internal Medicine
blue arrow Section Chief, West Haven VA Healthcare System
blue arrow Director, Clinical and Health Services Research (CHSR) Core
blue arrow Investigator, Development Core

Contact:
blue arrow amy.justice2@va.gov
blue arrow Ph: (203) 932-5711
 Amy C. Justice


Brief Bio:
Dr. Justice has conducted research focusing on outcomes in chronic HIV infection for more than 20 years. Her goal is to use HIV infection as a model for improving outcomes in chronic disease by studying the association between mutable mediators of clinical outcome in HIV and intervening on these mediators. She is the Principal Investigator on the Veterans Aging Cohort Study (VACS) (www.vacohort.org). This research, initially funded by career development awards from the National Institute on Aging and The Robert Wood Johnson Foundation, considers the complex roles of aging, symptoms, medical treatment, adherence, patient-provider relationships, disease severity, and medical and psychiatric comorbid illness in determining survival and quality of life for people with HIV infection. VACS has received 10 years of funding from NIAAA, the first 5 years supported expansion of the study to include HIV negative controls and additional study sites. The current renewal supports preparation for intervention studies. The study is focused on understanding the likely interactive and overlapping role of alcohol use and abuse in determining outcomes among veterans aging with HIV infection and comparing this role to age-race-site matched HIV negative veterans. For more information on the VACS study, visit www.vacohort.org. Dr. Justice has experience with observational data including analyzing large and complex databases, comparing results across databases, and conducting observational studies. She has studied predictors of survival and quality of life and is expert in the development, validation, and evaluation of multivariable prognostic models. Dr. Justice has published over 100 papers related to this work, served on twenty expert panels addressing issues of understanding and improving clinical outcomes in HIV infection, and chaired NIH special emphasis grant reviews. She currently serves as a steering committee member of theCenter for Health Quality, Outcomes, and Economic Research the Bedford Massachusetts VA HSR&D Center of Excellence, a member of the YCCI/CTSA Career Oversight Committee, and a mentor to the Indiana University-Moi University Kenya AIDS Care Initiative. Additionally she serves on the Center for Interdisciplinary Research on AIDS Executive Committee, National VA HIV-QUERI Executive Committee and the National VA HIV/HCV Technical Advisory Committee.

Areas of Expertise:
Alcohol,Clinical management,Comorbidity and aging,Secondary prevention

CIRA Affiliated Projects:
Alcohol Associated Outcomes among HIV+/- Aging Veterans
Funder:
National Institute on Alcohol Abuse and Alcoholism
Status: Active
Region:
U.S. - Connecticut, U.S. - Outside of CT.

Selected Publications:
In Press

Nader, C., Tsevat, J., Justice, A., Mrus, J., Levin, F., Kozal, M., Mattocks, K., Farber, S., Rogers, M., Erdos, J., Brandt, C., Kudel, I., Braithwaite, R.  (In Press). Development of an Electronic Medical Record Based Clinical Decision Support Tool to Improve HIV Symptom Management. AIDS Patient Care & STDs, (), .

2008

Braithwaite R.S., Conigliaro J., McGinnis K.A., Maisto S.A., Bryant K., Justice A.C.  (2008). Adjusting Alcohol Quantity for Mean Consumption and Intoxication Threshold Improves Prediction of Nonadherence in HIV Patients and HIV-Negative Controls. Alcoholism: Clinical and Experimental Research, 32(9), 1645-51.

Sueoka, K., Goulet, J.L., Fiellin, D., Rimland, D., Butt, A., Gibert, C., Rodriguez-Barradas, M.C., Bryant, K., Crystal, S., Justice, A.C.  (2008). Depression Symptoms and Treatment Among HIV Infected and Uninfected Veterans. AIDS and Behavior, (), 1090-7165.

Justice, A.C., Zingmond, D.S., Gordon, K.S., Fultz, S.L., Goulet, J.L., King, J.T. Jr., Bravata, D., Valdez, H., Kraft, M., Mattocks, K.  (2008). Drug toxicity, HIV progression, or comorbidity of aging: does tipranavir use increase the risk of intracranial hemorrhage?. Clinical Infectious Diseases, 47(9), 1226-30.

Maisto, S.A., McGinnis, K., Cook, R., Conigliaro, J., Bryant, K., & Justice, A.C.  (2008). Factor Structure of Leigh’s (1990) Alcohol Sex Expectancies Scale in Individuals in Treatment for HIV Disease. AIDS and Behavior, (), .

Rodriguez-Barradas, M.C., Goulet, J.L., Brown, S., Goetz, M.B., Rimland, D., Simberkoff, M.S., Crothers, K., and Justice, A.C.  (2008). Impact of Pneumococcal Vaccination by HIV Status on the Incidence of Pneumonia Among Subjects Enrolled in the Veterans Aging Cohort Five-Site Study. Clinical Infectious Diseases, 46(7), 1093-1100.

Braithwaite, R.S., Roberts, M.S., Chang, C.C., Goetz, M.B., Gibert, C.L., Rodriguez-Barradas, M.C., Shechter, S., Schaefer, A., Nucifora, K., Koppenhaver, R., Justice, A.C.  (2008). Influence of alternative thresholds for initiating HIV treatment on quality-adjusted life expectancy: a decision model. Annals of Internal Medicine, 148(3), 178-85.

Braithwaite, R.S., Goulet, J., Kudel, I., Tsevat, J., and Justice, A.C.  (2008). Quantifying the Decrement in Utility from Perceived Side Effects of Combination Antiretroviral Therapies in Patients with HIV. Value in Health, 11(5), 975-979.

2007

Braithwaite, R.S., Concato, J., Chang, C.C., Roberts, M.S., Justice, A.C.  (2007). A framework for tailoring clinical guidelines to comorbidity at the point of care. Archives of Internal Medicine, 167(21), 2361-2365.

Gange, S.J., Kitahata, M.M., Saag, M.S., Bangsberg, D.R., Bosch, R.J., Brooks, J.T., Calzavara, L., Justice, A.C., et al.  (2007). Cohort Profile: The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). International Journal of Epidemiology, 36(2), 294-301.

Gandhi, N.R., Skanderson, M., Gordon, K.S., Concato, J., Justice, A.C.  (2007). Delayed presentation for HIV care among veterans: A problem of access or screening?. Medical Care, 45(11), 1105-9.

Goulet, J.L., Erdos, J., Kancir, S., Levin, F.L., Wright, S.M., Daniels, S.M., Nilan, L., and Justice, A.C.  (2007). Measuring performance directly using the veterans health administration electronic medical record. Medical Care, 45(1), 73-79.

2006

Kraemer, K.L., McGinnis, K.A., Skanderson, M., Cook, R., Gordon, A., Conigliaro, J., Shen, Y., Fiellin, D.A., and Justice, A.C.  (2006). Alcohol Problems and Health Care Services Use in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Veterans. Medical Care, 44(8 Suppl 2), S44-S51.

Oursler, K.K., Goulet, J., Leaf, D., Akingicil, A., Katzel, L., Justice, A.C., and Crystal, S.  (2006). Association of comorbidity with physical disability in older HIV-infected adults: the veterans aging cohort five-site study. AIDS Patient Care & STDs, 20(11), 782-791.

Gordon, A.J., McGinnis, K.A., Conigliaro, J., Rodriguez-Barradas, M.C., Rabeneck, L., and Justice, A.C.; for the VACS-3 Project Team  (2006). Associations between Alcohol Use and Homelessness with Healthcare Utilization among Human Immunodeficiency Virus-Infected Veterans. Medical Care, 44(8 Suppl 2), S37-S43.

Diero, L., Kimaiyo, S., Siika, A.M., Shaffer, D., Rotich, J.K., Smith, F.E., Mamlin, J.J., and Einterz, R.M. *Justice AC*, Carter EJ, Tierney WM  (2006). Characteristics of patients with HIV infection. East African Medical Journal, 93(8), 424-433.

Fultz, S., Skanderson, M., Mole, L. A., Gandhi, N., Bryant, K., Crystal, S., and Justice, A. C.  (2006). Development and Verification of a "Virtual" Cohort Using the National VA Health Information System. Medical Care, 44(8 Suppl 2), S25-S30.

Braithwaite, R.S., Shechter, S., Roberts, M.S., Schefer, A., Bangsberg, D.R., Harrigan, P.R., Justice, A.C.  (2006). Explaining variability in the relationship between antiretroviral adherence and HIV accumulation. Journal of Antimicrobial Chemotherapy, 58(5), 1036-1043.

Mrus, J.M., Leonard, A.C., Yi, M.S., Sherman, S.N., Fultz, S., Justice, A.C., Tsevat, J.  (2006). Health-related quality of life in veterans and non-veterans with HIV/AIDS. Journal of General Internal Medicine, 21(), S39-S47.

Braitstein, P., Justice, A., Bangsberg, D.R.  (2006). Hepatitis C coinfection is independently associated with decreased adherence to antiretroviral therapy in a population-based HIV cohort. AIDS, 20(3), 323-331.

McGinnis, K,A,, Fultz, S,L,, Skanderson, M., Conigliaro, J,, Bryant, K,, Justice, A.C.  (2006). Hepatocellular carcinoma and non-hodgkin’s lymphoma: the roles of HIV, hepatitis C infection, and alcohol abuse. Journal of Clinical Oncology, 24(31), 5005-5009.

May, M.T., Sterne, J.A.C., Costagliola, D., Sabin, C.A., Phillips, A.N., Justice, A.C., Dabis, F., Gill, J., Lundgren, J., Hogg, R.S., de Wolf, F., Fätkenheuer, G., Staszewski, S., d’Arminio Monforte, A., and Egger, M.  (2006). HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis.. Lancet, 368(9534), 451-458.

Crothers, K., Butt, A.A., Gibert, C.L., Rodriguez-Barradas, M.C., Crystal, S. and Justice, A.C.  (2006). Increased COPD among HIV-positive compared to HIV-negative veterans. Chest, 130(), 1326-1333.

Cook, R.L., McGinnis, K.A., Kraemer, K.L., Gordon, A.J., Conigliaro, J., Maisto, S.A., Samet, J.H., Crystal, S., Rimland, D., Bryant, K.J., Braithwaite, R.S., and Justice, A.C.  (2006). Intoxication Before Intercourse and Risky Sexual Behavior in Male Veterans with and without Human Immunodeficiency Virus Infection. Medical Care, 44(8 Suppl 2), S31-S36.

Justice, A.C., Lasky, E., McGinnis, K.A., Skanderson, M., Conigliaro, J., Fultz, S.L., Crothers, K., Rabeneck, L., Rodriquez-Barradas, M., Weissman, S.B., and Bryant, K.; for the VACS 3 Project Team  (2006). Medical Disease and Alcohol Use Among Veterans with Human Immunodeficiency Infection: A Comparison of Disease Measurement Strategies. Medical Care, 44(8 Suppl 2), S52-S60.

Butt, A.A., Justice, A.C., Skanderson, M., Rigsby, M., Good, C.B., Kwoh, C.K.  (2006). Rate and predictors of treatment prescription for hepatitis C. GUT, 24(4), 585-591.

Conigliaro, J., Justice, A.C., Gordon, A.J., Bryant, K. for the VACS Alcohol and Behavior Change Research Group  (2006). Role of Alcohol in Determining Human Immunodeficiency Virus (HIV)-Relevant Outcomes: A Conceptual Model to Guide the Implementation of Evidence-Based Interventions into Practice. Medical Care, 44(8 Suppl 2), S1-S6.

Cotton, S., Puchalski, C.M., Sherman, S.N., Mrus, J.M., Peterman, A.H., Feinberg, J., Pargament, K.I., Justice, A.C., Leonard, A.C., Tsevat, J.  (2006). Spirituality and religion in patients with HIV/AIDS. Journal of General Internal Medicine, 21(), S5-S13.

Justice, A.C., Erdos, J., Brandt, C., Conigliaro, J., Tierney, W., and Bryant, K.  (2006). The Veterans Affairs Healthcare System: A Unique Laboratory for Observational and Interventional Research. Medical Care, 44(8 Suppl 2), S7-S12.

2005

Braithwaite, R.S., Justice, A.C., Chang, C.C., Fusco, J.S., Raffanti, S.R., Wong, J.B., and Roberts M.S.  (2005). Estimating the Proportion of Patients Infected with HIV who will Die of Comorbid Diseases. American Journal of Medicine, 118(8), 890-898.

2004

Shaffer, D.N., Njeri, R., Justice, A.C., Odero, W.W., Tierney, W.M.  (2004). Alcohol abuse among patients with and without HIV infection attending public clinics in Western Kenya. East African Medical Journal, 81(11), 594-8.

Fultz, S.L., McGinnis, K.A., Skanderson, M., Ragni, M.V. and Justice, A.C. for the VACS 3 Project Team  (2004). Association of Venous Thromboembolism with Human Immunodeficiency Virus and Mortality in Veterans. American Journal of Medicine, 116(6), 420-423.

Justice, A.C., Stein, D.S., Fusco, G.P., Sherrill, B.H., Fusco, J.S., Danehower, S.C., Becker, S.L., Hansen, N.I., Graham, N.M. and Chorus Program Team  (2004). Disease Progression in HIV-Infected Patients Treated with Stavudine vs. Zidovudine. Journal of Clinical Epidemiology, 57(1), 89-97.

Ledergerber, B, Lundgren, J.D., Walker, A.S., Sabin, C., Justice, A., Reiss, P., Ritt, F., d'Arminio Monforte, A., Weber, R., Fusco, G., Staszewski, Law, M., Hogg, R., Lampe, F., Gill, M.J., Castelli, F., Phillips, A.N., PLATO Collaboration  (2004). Predictors of CD4-positive T-cell count and mortality among HIV-1 infected individuals with virologic failure to all three antiretroviral drug classes. Lancet, 364(9428), 51-62.

Conigliaro, J., Madenwald, T., Bryant, K., Braithwaite, S., Gordon, A., Fultz, S., Maisto, S., Samet, J., Kraemer, K., Cook, R., Day, N., Roach, D., Richey. S. and Justice, A.C.  (2004). The Veterans Aging Cohort Study: Observational Studies of Alcohol Use, Abuse and Outcomes among HIV Infected Veterans. Alcoholism: Clinical and Experimental Research, 28(2), 313-321.

2003

Zingmond, D.S., Kilbourne, A.M., Justice, A.C., Wenger, N.S., Rodriguez-Barradas, M., Rabeneck, L., Taub, D., Weissman, S., Briggs, J., Wagner, J., Smola, S. and Bozzette, S.A.  (2003). Differences in Symptom Expression in Older HIV-Positive Patients: The Veterans Aging Cohort 3 Site Study and HIV Cost and Service Utilization Study Experience. Journal of Acquired Immune Deficiency Syndromes, 33(Suppl 2), S84-S92.

Conigliaro, J., Gordon, A.J., McGinnis, K., Rabeneck, L. and Justice, A.C. for the Veterans Aging Cohort 3-Site Study  (2003). How Harmful is Hazardous Alcohol Use and Addiction in HIV Infection: Do Providers Know Who is at Risk?. Journal of Acquired Immune Deficiency Syndromes, 33(4), 521-5.

King, J.T., Justice, A.C., Roberts, M.S. and Chang, C.C.H.  (2003). Long-Term HIV/AIDS Survival Estimation in the Highly Active Antiretroviral Therapy Era. Medical Decision Making, 23(1), 9-20.

Bisson, G., Gross, R., Miller, V., Weller, I., Walker, A., on behalf of the Writing Group  (2003). Monitoring of Long-Term Toxicities of HIV Treatments: An International Perspective. Journal of Acquired Immune Deficiency Syndromes, 17(17), 2407-17.

Fultz, S.L., Justice, A.C., Butt, A.A., Rabeneck, L., Weissman, S. and Rodriguez-Barradas, M.  (2003). Testing, Referral, and Treatment Patterns for Hepatitis C Virus Coinfection in a Cohort of Veterans with Human Immunodeficiency Virus Infection. Clinical Infectious Diseases, 36(8), 1039-1046.

McGinnis, K.A., Fine, M.J., Sharma, R.J., Skanderson, M., Wagner, J.H., Rodriguez-Barradas, M., Rabeneck, L. and Justice, A.C. for the VACS 3 Project Team  (2003). Understanding Racial Disparities in HIV: The Combined Use of Administrative Data and a Clinical Cohort. American Journal of Public Health, 93(), 1728-1733.

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